Your Digest for Tuesday, Apr 16, 2024 11:59 PM


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"MIC is the lowest concentration of an antibacterial agent expressed in mg/L (μg/mL) which, under strictly controlled in vitro conditions, completely prevents visible growth of the test strain of an organism [2]" Source
This is the persistence of antibiotic effect observed long after the serum concentration has fallen below the MIC.

Mnemonic: macrolides -> sequestered in macrophages.
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| Linezolid | Daptomycin | Vancomycin and Teicoplanin |
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Examples of this include β-lactams, carbapenems, monobactams, linezolid, linocosamides like clindamycin, and macrolides like erythromycin and vancomycin.Source


- Effort and exercise tolerance are preserved but ⭐**spasm can be triggered by exercise** during 'hot phase' of the condition. 


The "G" hormones are more sensitive

⭐Acromegaly

  1. Decreased secretion of other pituitary hormones -> ⭐most commonly gonadotrophins
    1. Menstrual dysfunction, vaginal atrophy, galactrorrhea
  2. Hyperprolactinaemia - either increased [[#Prolactin]] secretion from the somatotroph adenoma or inhbition of dopaminergic inhibition -> causes galactrorrhea
    1. Soft tissue overgrowth - large tongue (macroglossia), carpal tunnel syndrome + the other classic ones
      1. heart: cardiomyopathy and LVH with diastolic dysfunction and arrhythmias - secondary to hypertension
      2. Hypertension: GH-IGF-I excess -> enhanced sodium- and water retention -> expansion of plasma volume and increased systemic vascular resistance. Source
      3. Hyperinsulinaemia may also stimulate salt and water retention Source
    2. colonic neoplasms

Part of a constellation of conditions including fibromyalgia, chronic fatigue syndrome.
2. altered bowel habits - either diarrhoea or constipation +/- intervals of normal bowel habits.

[!INFO]
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[!NOTE] ROME IV criteria
?symptoms can worse in the premenstrual period.

+ **Mebeverine** (antispasmodic)
+ Explantion of symptoms, **CBT**, hypnotherapy, 
+ **SSRI** -Constipation predomimant IBS , TCA -diarrhoea predominant IBS



|Pergolide, Lisuride, Cabergoline, Bromocriptine | pramipexole, ropinirole, rotigotine |
| PelicanMnemonic.png | |
⭐🚩None of the drugs in Parkinson's alter disease progression.
[!INFO] motor complications of treatment

  1. End of dose wearing off effect
  2. Choreiform movements / dyskinesias
  1. On off phenomena

- *Nerve growth factor* : **a key element of inflammatory pain**. It induces hyperalgesia by up-regulating the transcription of genes encoding receptors, ion channels, and neuropeptides. [Source](https://www.sciencedirect.com/science/article/pii/S0021925820756589)


Class mechanism
Beta lactams, Cephalosporin Inhibit cell wall synthesis
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  1. Fusidic acid
  2. and lincosamide - clindamycin.
  3. macrolides - erythromycin, azithromycin , clarithromycin
  4. aminoglycoside
  5. tetracycines
  6. chloramphenicol

- Focal onset *impaired awareness* seizures: aka ⭐*complex partial* seizures.